Wiki billing preventative exam with 99213?

[avrilw]

Healthy Options Molina (Medicaid) is telling me that we are to bill a preventative visit for an adult using an office visit like 99213 with a dx indicating a preventative exam. That would be incorrect though right since those codes are only for problems?

Has anyone else billed Molina with a Preventative code (99396) for an adult and gotten paid?

 

[Restevez1989]

Proper coding guidelines will tell you that is incorrect however each insurance plan has there own set of guidelines they follow. I would call the insurance and clarify what will they actually pay and inform them that is not correct. You can also report them to CMS.